Basic Information
| Provider Information | |||||||||
| NPI: | 1922082049 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AEBY | ||||||||
| FirstName: | TOD | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1319 PUNAHOU ST | ||||||||
| Address2: | STE 824 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968261001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082036519 | ||||||||
| FaxNumber: | 8089552174 | ||||||||
| Practice Location | |||||||||
| Address1: | 1319 PUNAHOU ST | ||||||||
| Address2: | STE 801 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968261001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089495305 | ||||||||
| FaxNumber: | 8089552174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 07/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD6114 | HI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 059597 | 05 | HI | MEDICAID |